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Paula Prezioso, MD

Eczema In Babies

Is it just dry skin, or does baby have eczema? Here’s the real deal on how to spot eczema and how to help baby if he has it.

What is eczema in babies?

Eczema, aka atopic dermatitis, is a common skin disorder causing itchy bumps — and it’s also a chronic condition. In other words, while some babies outgrow its severity over time, others will have eczema long term. Eczema can make baby’s skin thicken or change its pigmentation.

What are the symptoms of eczema in babies?

Eczema looks like red, dry patches of skin. It usually shows up near joints and skin creases. On babies, the patches might show up on the cheeks and body. In older children, the patches tend to be in the creases of their arms and legs.

In infants under two months of age, seborrhea is often confused with eczema. Seborrhea present with oily scales, often on the face and scalp (where it’s called "cradle cap"), tends to resolve on its own or responds to mild oils or lubricants.

Are there any tests for eczema in babies?

Not really. Baby’s pediatrician will likely base their diagnosis on baby’s medical history, how the rash looks and any family history you can relay. There could be tests to rule out other conditions the doc may suspect.

How common is eczema in babies?

It’s the most common skin disorder in children, and it’s often seen in young infants. Every new parent wants their child to look like an Anne Geddes photo, so pediatricians tend to see a lot of babies in their offices with eczema!

How did my baby get eczema?

It’s hard to say. There seems to be a link between eczema and allergies — kids with eczema are more likely to also suffer from allergies and asthma. Usually, certain things trigger baby’s eczema outbreaks, like dryness, heat and chemical irritants (even lotion and hand sanitizer!). There’s often a family history of eczema, allergies and asthma, so maybe it runs in the family. It’s important to discuss your family history and baby’s medical history with the pediatrician in order to successfully treat baby’s eczema, since your goal won’t just be to treat the symptoms, but to prevent the outbreaks as well.

What’s the best way to treat eczema in babies?

The first line of treatment for eczema is moisturizing the skin. Limiting bathing, which washes away the body’s natural oils, is the first step. Emollients — try a petroleum-based one — can decrease dryness and help prevent the discomfort baby can get when his skin gets cracked and red. In more severe cases, low-dose anti-inflammatory ointments can be used — the most common are hydrocortisone ointments. These have a steroid base and are available in low doses over the counter and in higher concentrations through a prescription from a pediatrician. Be sure to be extra-careful with these ointments since overuse can cause complications such as thinning of the skin.

Try to get to the bottom of what could be triggering baby’s eczema — it could be anything from laundry detergent and food to stuff in the environment. If you can pinpoint baby’s triggers, you can make special steps to avoid them.

The typical course of eczema is significant improvement in the first year, with continued improvement over the first few years. Rarely, children with severe eczema are referred to a dermatologist where research is being done on the use of immune system modulators. Thankfully, it’s the rare child that needs more than fewer baths and some petroleum jelly!

What can I do to prevent my baby from getting eczema?  

You can’t, really. But you can prevent outbreaks if you figure out what baby’s eczema triggers are and keep her away from them.

What do other moms do when their babies have eczema?

“Grace had eczema pretty badly. She had it all over her arms, legs, belly and back. It just looked like really dry, slightly bumpy skin. It also got bright-red when she got in the water for a bath. The doc gave us a cream that we had to apply four times a day, and it went away. Then it came back about three weeks after I stopped using the cream, but not nearly as bad as the first time. I applied the cream a few more times, and it hasn't been back since. It's been about three weeks now.”

“My older son has it on his arms, face and calves. Strangely, his started [in the summer] last year, when he was about nine months old. I always thought that it was triggered by the sunblock I was using, but as the summer ended, it stuck around, and he still has it. Sometimes it looks kind of like tiny zits, or like poison ivy. It doesn't seem to bother him at all, but I don't like the way it looks. I hope it goes away.”
“My son has it on his face and legs. I use Aquaphor ointment on the patches for the "flare-ups." Once that clears, we use regular Eucerin lotion after every bath, and his flare-ups have been really minimal.”

Are there any other resources for eczema in babies?

American Academy of Pediatrics’